Kornimate/medical-research-clean huggingface dataset:
hmb enriched amino acids to reverse muscle loss in cirrhosis

Conditions: Cirrhosis, Liver

Summary: loss of skeletal muscle mass or sarcopenia is the most common and potentially reversible complication in cirrhosis that increases morbidity and mortality before, during and after liver transplantation. no proven treatments exist for the prevention or reversal of sarcopenia in cirrhosis, primarily because the mechanisms responsible for this are unknown. based on compelling preliminary studies and those of the co investigator, investigators hypothesize that the mechanism of reduced skeletal muscle mass in cirrhosis is due to a myostatin mediated impaired mtor (mechanistic target of rapamycin) signaling resulting in reduced protein synthesis and increased autophagy. investigators further postulate that leucine, a direct stimulant of mtor, will reverse the impaired mtor phosphorylation in the skeletal muscle of cirrhotics. the consequent increase in protein synthesis reduced autophagy will result in an increase in skeletal muscle mass. investigators will test these hypotheses by quantifying the response to acute and long term (3 month) administration of hydroxymethyl butyrate (hmb) enriched essential amino acid compared with an isonitrogenous isocaloric non-essential balanced amino acid mixture (does not stimulate protein synthesis) in cirrhotic patients. fractional protein synthesis rate (fsr) in skeletal muscle, responses of the molecular regulatory pathways of skeletal muscle protein synthesis, and autophagy flux will be quantified in the acute and long term protocols. tracer studies using l-\[d5\]-phenylalanine (phe) as a primed constant infusion (prime 2µmol.kg-1.hr-1; constant 0.05 µmol.kg-1.hr-1) with and l \[ring-d2\] tyrosine, forearm plethysmography, and sequential skeletal muscle biopsies (total of 3 per study subject) will be used to quantify these outcomes. anthropometric, clinical and body composition measures will be additional outcome measures for the long term intervention. expression of regulatory signaling proteins, myostatin, igf-1 (insulin like growth factor) , phospho-akt, phospho-ampk (activated protein kinase), phospho-mtor and phospho-p70s6k will be quantified by western immunoblots. autophagy flux will be measured by quantifying expression of the autophagosome proteins.


Eligibility criteria:
inclusion criteria: * diagnosis of cirrhosis of the liver * child-pugh score of 5-8 exclusion criteria: * recent gastrointestinal bleeding (\<3m) * active infection * overt encephalopathy * renal failure on dialysis * pedal edema * uncontrolled diabetes (hba1c \> 7.9mg/dl) * advanced cardiac, lung, kidney disease * metastatic cancer * medications that alter muscle protein metabolism * pregnancy * recent bowel resection or gastric bypass surgery, * inr \>1.7, platelets \ 2mg/dl * medications that interfere with blood clotting
comparative study of amniotic membrane wound graft in the management of diabetic foot ulcers

Conditions: Diabetic Foot Ulcer

Summary: the purpose of this study is to determine whether the epifix human amniotic membrane is effective in the treatment of diabetic foot ulcers.


Eligibility criteria:
inclusion criteria: * male or female age 18 or older * informed consent must be obtained * patient's ulcer must be diabetic in origin and larger than 1cm2. debridement will be done prior to randomization. subject's informed consent for participating in this study, must be obtained prior to proceeding with sharp debridement. * patients with type 1 or type 2 diabetes (criteria for the diagnosis of diabetes mellitus per ada). * ulcer must be present for a minimum of four weeks direction, with documented failure of prior treatment to heal the wound. * patient's ulcer must exhibit no clinical signs of infection. * patient is of legal consenting age. * patient is willing to provide informed consent and is willing to participate in all procedures and follow up evaluations necessary to complete the study. * serum creatine less then 3.0mg/dl * hba1c less than 12% * patient has adequate circulation to the affected extremity, as demonstrated by one of the following within the past 60 days: * dorsum transcutaneous oxygen test (tcpo2) with results ≥30mmhg, or * abis with results of ≥0.7 and ≤1.2, or * doppler arterial waveforms, which are triphasic or biphasic at the ankle of affected leg exclusion criteria: * patients presenting with an ulcer probing to bone (ut grade iiia-d). a positive probe-to-bone will be confirmed when bone or joint can be felt with a sterile, ophthalmological probe. * patients whose index diabetic foot ulcers are greater than 25cm2. * patients considered not in reasonable metabolic control, confirmed by an hba1c greater than 12% within previous 90 days, * patients whose serum creatinine levels are 3.0mg/dl or greater. * patients with a known history of poor compliance with medical treatments. * patients who have been previously randomized into this study, or are presently participating in another clinical trial. * patients who are currently receiving radiation therapy or chemotherapy. * patients with known or suspected local skin malignancy to the index diabetic ulcer. * patients on anticoagulant medication will as in any surgical procedure, be monitored according to the protocols employed at the enrolling center. * patients diagnosed with autoimmune connective tissues diseases. * non-revascularizable surgical sites. * active infection at site. * any pathology that would limit the blood supply and compromise healing. * patients that have received a biomedical or topical growth factor for their wound within the previous 30 days. * patient who are pregnant or breast feeding. * patient who are taking medications that are considered immune system modulator which could affect graft incorporation. * allergy to gentamycin or streptomycin.
wireless monitoring for clinical deterioration

Conditions: Inpatient Facililty Diagnoses

Summary: the study evaluates whether implementing a wireless monitoring system for patients admitted to hospital wards reduces mortality and cardiopulmonary failure.

the trial is designed as a stepped-wedge cluster rct. hospital wards (which constitute clusters in this design) will be randomized to have wireless monitoring, 7 wards at a time, with each 7 wards constituting a sequence. the study consists of 5 periods of two-month sequences followed by a one-month transition time with a phased introduction of the intervention. in the first period, all wards will have no wireless monitoring. after a baseline period of 2 (+1 washout) months, the intervention (monitoring system) will be implemented in a randomly selected new sequence every 3-month period until the intervention is implemented in all sequences.

Eligibility criteria:
inclusion criteria: ward level inpatient wards, defined as wards used to manage adult inpatients. patient level 1. aged 14 years or older 2. checked in as inpatient status to one of the study wards exclusion criteria: ward level 1. cardiology, pediatric, obstetric wards 2. icus and emergency departments 3. operating rooms 4. outpatient clinics 5. daycare wards, endoscopy, outpatient procedure areas, hemodialysis units patient level no commitment for full life support at the time of arrival to the study ward (designated as do-not-resuscitate status)

Keywords: inpatients wireless monitoring mortality cardiopulmonary failure
detecting auricular points in koa by a novel apd

Conditions: Osteoarthritis, Knee

Summary: this is a pilot diagnostic accuracy study conducted to assess the diagnostic ability of a novel apd for auricular point detection among patients with knee osteoarthritis (koa), as compared with an already commercialized device.

the present study is a pilot diagnostic accuracy study conducted to assess the diagnostic ability of a novel apd for auricular point detection among patients with knee osteoarthritis, as compared with an already commercialized device. the investigators will test if the novel apd could provide a more reliable and quantifiable diagnosis than traditional devices currently available in the market; they will also use the apd device to test whether the cutaneous electrical impedance detected from the corresponding auricular points by the novel device is the lowest in the knee and lower limb area in the koa population. as a pilot study, 12 patients with koa will be recruited from the department of anesthesiology, queen mary hospital, the university of hong kong. 12 healthy subjects will be recruited from the university community. auricular acupoint detection will be accomplished with the new device and a control device. the electrical impedance will be measured and recorded. patient's condition will also be evaluated by the knee injury and osteoarthritis outcome score (koos) and the western ontario and mcmaster universities osteoarthritis index (womac). the specificity and sensitivity of the auricular point detection by the apd device will be calculated. cohen's kappa coefficient (κ) will be used to test the inter-methods reliability, test-retest reliability, and inter-tester reliability. moreover, the pearson correlation coefficient will be used to test the correlation between the electrical impedance of the auricular point of knee and the koos score and womac score.

Eligibility criteria:
inclusion criteria: * average daily knee pain \>=5 point measured by a 10-point vas scale; * diagnosed koa of any reason; * the different patient categories; * patients with knee osteoarthritis enrolled for knee arthroplasty, osteotomies around the knee, cartilage repair, or anterior cruciate ligament-deficient knees enrolled for anterior cruciate ligament reconstruction; * surgical plan in the coming month after inclusion; * provide written inform consent; * free of any other diagnosed psychological conditions; exclusion criteria: * with any other diseases such as cardiovascular, renal, neurological, digestive, hepatic, respiratory disease; * pregnancy or lactation; * participation in a clinical study that may interfere with participation in this study; * history of or current tobacco, alcohol use; * anything that would place the individual at increased risk or preclude the individual's full compliance with or completion of the study; * unable to provide written informed consent due to any reason;

Keywords: auricular point detection knee osteoarthritis pain
impact of hlnatural immune supplement on colds

Conditions: Immune System Diseases

Summary: according to the centers of disease control and prevention (cdc) adults will have an average of 2-3 colds per year. most colds will last approximately 7-10 days. the symptoms of colds could include cough, sore throat, runny nose, body aches, fevers, headaches and fatigue. a cold can affect your activity such as going to work, interrupting your sleep and your day to day activities. the test product contains all natural ingredients which have been combined into a powder to be taken in water at the sign of a cold.

at the onset of a cold, mix 1 packet of the drink-mix product in 6-8 oz. of hot water. drink the drink mix twice a day until symptoms are gone or 18 days, whichever comes first. 1. complete the screening survey. 2. sign the econsent if approved. 3. complete the baseline survey, demographic form, and medication and supplements form. 4. receive test product and log into study portal and complete supplement receipt form. this will mark the start of your participation in this study. 5. once you have a cold, complete the symptom survey. 6. take test product. 7. write down any adverse or ill effects any time after taking the test product. 8. record if you took any additional medications or supplements daily during the course of your cold. 9. note any final adverse events and complete the exit form.

Eligibility criteria:
inclusion criteria: adult candidates in the general population who are in good health and are seeking herbal remedies to reduce the duration of their common cold symptoms when they should arise. participants will be deemed to be in good health if they do not report any of the medical conditions asked about in the screening questionnaire. exclusion criteria: * age \< 18 years old * unwilling to try the test product during their first cold experience in the trial * has any of the following medical conditions: * chronic seasonal allergies * allergy to any of the following ingredients: echinacea, ivy extract, camu camu, vitamin c, ginger, turmeric, zinc or a known allergy to guar gum, monk fruit, citric acid, natural flavors. * asthma * current cold infection * currently taking antimicrobial or antiviral medication * alcohol consumption more than 7 drinks per week or more than 3 drinks per occasion * routine recreational drug use * chronic renal disease * chronic liver disease * known autoimmune or immunodeficiency disorders * medically treated atopy or allergy * pregnant or breastfeeding
pulmonary hypertension and anastrozole trial

Conditions: Pulmonary Arterial Hypertension

Summary: the primary objectives of this study are to determine whether the study drug, anastrozole may improve six minute walk distance at six months compared to placebo and to assess safety and side effects up to twelve months in pulmonary arterial hypertension (pah).


Eligibility criteria:
inclusion criteria: * previous documentation of mean pulmonary artery pressure \> 25 mm hg with a pulmonary capillary wedge pressure (or left ventricular end-diastolic pressure) \ 3 wu at any time before study entry. * diagnosis of pah which is idiopathic, heritable, drug- or toxin-induced, or associated with connective tissue disease, congenital heart disease, portal hypertension, or hiv infection and receiving treatment for pah. * most recent pulmonary function tests with fev1/fvc \>50% and either a) total lung capacity \> 70% predicted or b) total lung capacity between 60% and 70% predicted with no more than mild interstitial lung disease on computerized tomography scan of the chest. * ability to perform six minute walk testing without significant limitations in musculoskeletal function or coordination. * if female, post-menopausal state, defined as: * \> 50 years old and a) have not menstruated during the preceding 12 months or b) have follicle-stimulating hormone (fsh) levels (\> 40 iu/l) or * \ 40 iu/l) or * having had a bilateral oophorectomy. * informed consent. exclusion criteria: * age \< 18. * current treatment with estrogen, hormone therapy, or anti-hormone therapy (tamoxifen, fulvestrant, etc.) * who class iv functional status. * history of invasive breast cancer. * clinically significant untreated sleep apnea. * left-sided valvular disease (more than moderate mitral valve stenosis or insufficiency or aortic stenosis or insufficiency), pulmonary artery or valve stenosis, or ejection fraction \< 45% on most recent echocardiography (within 1 year). * initiation of pah therapy (prostacyclin analogues, endothelin-1 receptor antagonists, phosphodiesterase-5 inhibitors, riociguat, selexipag) within three months of enrollment; the dose must be stable for at least three months prior to baseline visit. pah therapy which is stopped and then restarted or has dose changes which are not related to initiation and uptitration will be allowed within 3 months prior to the baseline visit. * hospitalized or acutely ill. * renal failure (creatinine ≥ 2.0). * hypercalcemia. * severe osteoporosis: t score -2.5 to -3.4 without bone modifying treatment or t score = - 3.5 or lower * child-pugh class c cirrhosis. * current or recent (\< 3 months) chronic heavy alcohol consumption. * enrollment in a clinical trial or concurrent use of another investigational drug or device within 30 days of screening visit.

Keywords: randomized controlled trial clinical trial anastrozole pulmonary hypertension pulmonary arterial hypertension pah
tui 3d in diagnosis of placenta accreta: comparison with gray-scale and color doppler techniques

Conditions: Placenta Accreta

Summary: the purpose of this study is to evaluate the potential of the 3 d tui view in diagnosis of morbidly adherent placenta in comparison to 2d grayscale, color doppler and intraoperative findings.

* this is a prospective study which will include 50 patients who will be selected from the outpatient and inpatient obstetric ain shams university maternity hospital. * all patients will undergo the following : 1. history taking 2. clinical examination. 3. for each patient, the whole placenta will be scanned in a systematic fashion using both 2d grayscale and 2d power doppler ultrasound then displayed by 3d tui to determine whether those patients suspected of having advanced invasive placentation.

Eligibility criteria:
inclusion criteria: 1. history of previous cesarean section or hysterotomy. 2. placenta previa with its lower edge covering the scar of previous cesarean section 3. from 28 wks to full term. exclusion criteria: 1. multiple pregnancies. 2. medical disorder as diabetes mellitus, hypertension. 3. obese patients. bmi \> 30 4. intrauterine growth retardation.
safety and efficacy of celecoxib versus naproxen in the 6-month treatment of knee osteoarthritis

Conditions: Osteoarthritis, Knee

Summary: to compare the safety and efficacy of celecoxib versus naproxen for the treatment of knee osteoarthritis


Eligibility criteria:
inclusion criteria: * osteoarthritis of the knee as defined by the american college of rheumatology criteria in a flare state at baseline visit * functional capacity classification of i-iii exclusion criteria: * inflammatory arthritis or gout/pseudo-gout with an acute flare within the past 2 years (subjects with fibrositis or fibromyalgia will not be excluded) * received acetaminophen within 24 hours of the baseline visit * acute joint trauma at index joint within the past 3 months with active symptoms * history of gastrointestinal (gi) perforation, obstruction, or bleeding * diagnosed or treated for gi ulcer within 60 days prior to first dose of study medication * received corticosteroids or hyaluronic acid within certain timeframe before study
24-hour iop fluctuation profile recorded with sensimed triggerfish in primary open-angle glaucoma (poag) patients after cataract surgery

Conditions: Glaucoma

Summary: the purpose of this study is to determine the relationship between intraocular pressure (iop) fluctuations of glaucoma patients as recorded with an iop-sensing contact lens (sensimed triggerfish®), during two 24-hour periods, before and after cataract surgery. this device has previously been investigated and shown to be safe and well tolerated.


Eligibility criteria:
inclusion criteria: * subject is able to comply with the study procedures * 18-80 years old * subjects diagnosed with glaucoma, based on presence of repeatable visual field loss and/or glaucomatous optic neuropathy based on masked review of optic disc stereophotographs and under ocular hypotensive treatment, or diagnosed with ocular hypertension, with an iop of \> 22 mmhg at the screening visit and under ocular hypotensive treatment. * subject has consented to be in the trial * visual acuity of 20/200 or better * presence of cataract requiring phacoemulsification with lens exchange * ability to understand the character and individual consequences of the study * for women of childbearing potential, adequate contraception exclusion criteria: * subjects presenting with any of the following criteria will not be included in the trial: * subjects with contraindications for wearing contact lenses * severe dry eye syndrome * keratoconus or other corneal abnormality * conjunctival or intraocular inflammation * eye surgery prior to and throughout the study. * full frame metal glasses during sensimed triggerfish® monitoring * known hypersensitivity to silicone, plaster or ocular anesthesia (proparacaine) * pregnancy and lactation * simultaneous participation in other clinical studies

Keywords: relationship iop fluctuations glaucoma cataract surgery sensimed triggerfish
vitamin d in hiv-infected patients on haart

Conditions: Vitamin D Deficiency; HIV

Summary: this is a research study to look at vitamin d deficiency (low levels) in men and women with hiv. as part of your regular medical care, you will be screened for vitamin d deficiency. if your levels are low, and you choose to start using vitamin d supplements, the investigators would like to take some blood before and after you start using vitamin d to see how this affects your levels of hiv, t cells, cholesterol, and other blood levels. the investigators will provide you with vitamin d supplements for the first 24 weeks (6 months) of the study. if you and your physician decide that you should continue taking vitamin d supplements after that time, you will be responsible for purchasing your own vitamin d supplements.


Eligibility criteria:
inclusion criteria: * hiv-positive men and women age 18 and older. * hiv-1 rna documented to be \< 200 copies/ml on their current art regimen, with supporting viral load documentation in the 24 weeks prior to study entry. * subjects must receive primary hiv care at the ucla care center. * subjects must be undergoing screening for vitamin d deficiency by their primary care provider at the time of study entry, or have undergone vitamin d screening in the 90 days prior to consent without yet initiating vitamin d supplementation (for insufficient subjects). * ability and willingness of subject to provide informed consent exclusion criteria: * use of vitamin d supplementation (not including 400 iu daily, the amount in a standard multivitamin) at the time of screening. * hiv-infected subjects not on art. * hiv-infected subjects not suppressed on their current art regimen (hiv-1 rna \> 200 copies/ml in the 6 months prior to screening).

Keywords: hiv vitamin d haart
the angiography characteristic of free wall ruptrue in stemi

Conditions: ST-Elevation Myocardial Infarction

Summary: to analyze whether the location of myocardial infarction and infarct related artery are related to fwr.

to know the characteristic of fwr that different location of stemi and coronary distribution

Eligibility criteria:
inclusion criteria: 1. patients had to be ≥18 years of age, be admitted for stemi 2. accord with stemi diagnostic criteria 3. stemi patients anticipated to undergo angiography exclusion criteria: 1. pregnant 2. acute stroke 3. aortic dissection

Keywords: stemi ruptrue angiography
does local injury of the endometrium improve controlled ovarian hyperstimulation (coh) + intrauterine insemination (iui) outcome?

Conditions: Infertility; Implantation Failure

Summary: it was previously demonstrated in in vitro fertilization (ivf) patients that local injury of the endometrium during a spontaneous menstrual cycle that precedes ivf treatment doubled the rates of implantation and pregnancy. the hypothesis of our present study is that the endometrial injury procedure will have the same beneficial effect in patients undergoing controlled ovarian hyperstimulation (coh) combined with intrauterine insemination (iui).

in order to test our hypothesis, we will perform the simple procedure of local injury of the endometrium using a "pipelle" biopsy catheter during the spontaneous menstrual cycle that precedes a coh + iui treatment.

Eligibility criteria:
inclusion criteria: * age 18-38. * infertility. * patients undergoing iui treatment. * at least one failed iui cycle. exclusion criteria: * indication for ivf treatment. * known pelvic inflammatory disease(pid).

Keywords: endometrial biopsy implantation uterine receptivity infertility controled ovarian hyperstimulation intra uterine insemination